Relevance of septal hypokinesia as a finding in myocardial perfusion gated-SPECT

To identify septal hypokinesia (SH) with signs of right ventricular (RV) overload. Materials and methods. Prospective study of consecutive patients divided into cases with SH (n = 39) and controls without SH (n = 27). Subjects with septal perfusion defects and alterations in conduction were excluded. Images were obtained after injection of 20 mCi (740 MBq) of technetium tracer. The perfusion and septal mobility, RV and left ventricle values were quantified and other clinical parameters were obtained. Multivariate non-parametric tests and Pearson's correlation tests were applied. RV perfusion was higher in the case group (31.7% vs 27.5%, p = 0.012). 35.9% of cases had undergone cardiac surgery (CS) in the past. A higher number of subjects with valve diseases (VD) was found in the case group (23.1% vs 3.7%, p = 0.031); the same occurred with smoking (46.2% in cases vs. 11.1% in controls, p = 0.05). Correlation was obtained between septal motion and RV perfusion (-0.374, p = 0.015 bilateral), and between septal and RV wall motion (0.299, p = 0.015 one-sided). This test has been scarcely applied in RV pathology; this entity has great repercussion on the prognosis of patients with heart failure. These findings may clarify certain aspects of its physiopathology. According to our study, SH is associated with the degree of RV perfusion and wall motion, as well as the presence of history of CS, VD and smoking. Identificar la hipocinesia septal (HS) con signos de sobrecarga del ventrículo derecho (VD). Estudio prospectivo de pacientes consecutivos divididos en casos (n = 39), con HS y controles (n = 27) sin HS. Se excluyeron sujetos con defectos septales de perfusión, así como alteraciones de la conducción. Las imágenes se obtuvieron tras la inyección de 20 mCi (740 MBq) de trazador tecneciado. Se cuantificaron los valores de perfusión y movilidad septal del VD y del ventrículo izquierdo, y se obtuvieron otros parámetros clínicos. Se aplicaron pruebas no paramétricas multivariantes y prueba de correlación de Pearson. La perfusión del VD fue mayor en el grupo de casos (31,7% frente a 27,5%, p = 0,012). El 35,9% de los casos había sido sometido a cirugía cardíaca (CC) en el pasado. Se halló un mayor número de sujetos con valvulopatías (VP) en el grupo de casos (23,1% frente a 3,7%, p = 0,031), lo mismo ocurrió con el hábito tabáquico (46,2% en casos frente a 11,1% en controles, p = 0,05). Se obtuvo una correlación entre la movilidad septal y la perfusión del VD (−0,37